Global Health Security:
Opportunities and Challenges
Claire Standley & Erin Casey
Biosecurity Engagement Program
U.S. Department of State
5 th annual AFENET Conference,
Addis Ababa, November 2013

Claire Standley:
• Historical perspective of Global Health Security
• Modern GHS landscape
• Examples from outside Africa
Erin Casey
• Linking veterinary education with epidemiology
• One Health and GHS
• Examples from within Africa

“The activities required…to minimize vulnerability to acute public health events that endanger the collective health of populations living across…international boundaries”. (WHO)
Focus on health problems that transcend national borders
Human and
Animal
Health
B
E
P
Security
Focus on elimination or dismantlement of biological weapons infrastructure
Chronic disease
Emerging disease
Dual use technologies
Bio terrorism

FOCUS EFFORTS HERE
BEP
Partner
Country
SUSTAINABILITY
BEP GOALS:
• Institutionalize biorisk management
• Promote compliance with international frameworks
• Decrease opportunity for misuse of pathogens

• Tularemia used as weapon by Hittites in 1300s
• “Black Death” in Europe (Yersinia pestis) caused socio-economic chaos
• Smallpox introduced into Americas by early
European colonists destroyed whole societies.
• Better understanding of transmission in 19 th century

• First UN Security Council Resolution on health adopted in 2000, recognizing the destabilization threat of HIV/AIDS.
• Anthrax attacks in U.S. in 2001 – threat of biological agents in hands of non-state actors.
• Global pandemics: SARS, H1N1

The Modern Health Security
Landscape
• Greater global connectivity than ever before
“An outbreak in Indonesia can reach Indiana within days, and public health crises abroad can cause widespread suffering, conflict, and economic contraction….”
-President Obama, May 2009

The Modern Health Security
Landscape
• Greater global connectivity than ever before
• Internet as a resource for responsible research but also nefarious purposes

The Modern Health Security
Landscape
• Greater global connectivity than ever before
• Internet as a resource for responsible research but also nefarious purposes
• Mobile, capable, and organized trans-national terrorist groups around the world

The Modern Health Security
Landscape
• Greater global connectivity than ever before
• Internet as a resource for responsible research but also nefarious purposes
• Mobile, capable, and organized trans-national terrorist groups around the world
• Emerging infectious diseases and diffusion of advanced biotechnologies

Emerging Infections: The last
30 years
??
Source: Nature 430, 242-249(8 July 2004)

“ We must come together to prevent, and detect, and fight every kind of biological danger—whether it ’ s a pandemic like H1N1, or a terrorist threat, or a treatable disease.
”
President Obama, United Nations General
Assembly Address, September 22, 2011

International Frameworks
Related to Health Security
• Biological Weapons Convention (1972)
– Recent emphasis on responsible conduct/dual-use
• International Health Regulations (2005)
• Lots of national policies and guidelines
Adopted by 194
States Parties
Entered into force
States report meeting all core capacity requirements
OR
Request extension
States report meeting all core capacity requirements
OR
Request 2nd extension
2005 2007
States assess core capacities
2009
Plan/implement capacity building
2012 2014

Examples from outside Africa
• Support for national bodies that promote health security
– Iraq National Biorisk Management Committee
• Multisectoral coordination for outbreak response
– Training of MoH first responders and law enforcement in Middle East to respond to CBW event

Africa
Erin Casey, MS, DVM
Program Officer
Biosecurity Engagement Program
Cooperative Threat Reduction
5 th annual AFENET Conference,
Addis Ababa, November 2013

Epidemiology and Veterinary Medicine
• Education curriculum
– Global issue
• Importance of partnering the fields
– Better understanding of disease
– Maximize training http://trialx.com
www.phrei.org

Veterinary Medicine and
Epidemiology / Environment and
Human Medicine www.onehealthinitiative.com
One Health
Synergistic Effect

http://bio-risk.org/html/biosecurity.html
cvm.msu.edu
• Biorisk: risk associated with biological materials
• Biosafety: containment principles, technologies, and practices implemented to prevent unintentional exposure to pathogens and toxins, or their unintentional release
• Biosecurity: measures designed to prevent the loss, theft, misuse, diversion, or intentional release of pathogens and toxins

Health Security:
From collection to containment
FOCUS EFFORTS HERE
• Sample collection
• Sample transport
• Laboratory analysis
• Communication
 security
Health Security
MULTI-SECTORAL APPROACH

• Development and history
• Management plan in the event of an outbreak
• Success stories

Integrated Disease Surveillance and
Response
• Adopted in 1998
• Framework for strengthening national public health surveillance and response systems http://stacks.cdc.gov/view/cdc/11943 http://www.who.int/csr/labepidemiology/projects/ surveillance/en/

• Ebola Virus (Uganda)
July – August 2012
• Quick, organized response
– Contained outbreak
– Minimized impact www.brettrussell.com
• National and international partnerships
• Veterinary / One Health

Continued Success Stories in Africa
• Field epidemiology capacity development
• Public health laboratory capacity development
• Public health disease surveillance and effective response
• Networking and collaboration

Health Security:
An integrated approach
FOCUS EFFORTS HERE
Regional Global www.healthypeople.gov

Erin Casey, MS, DVM
Program Officer
Biosecurity Engagement
Program
US Department of State
CaseyED@state.gov
Claire Standley, PhD
Program Officer
Biosecurity Engagement
Program
US Department of State
StandleyCJ@state.gov